title: Does off-pump coronary artery bypass grafting negatively impact long-term survival and freedom from reintervention?
abstract: Recently published evidence has raised concerns about worse late mortality and increasing need for reintervention after off-pump coronary artery bypass grafting. We undertook this study to assess the impact of off-pump coronary artery bypass grafting on survival and freedom from reintervention at 10 years. From January 2002 to December 2002, 307 consecutive patients who had isolated multivessel off-pump coronary artery bypass grafting at our institution were compared to a control group of 397 patients that underwent multivessel on-pump coronary artery bypass grafting during the same period. In addition, univariate and risk-adjusted comparisons between the two groups were performed at 10 years. Kaplan-Meier survival was similar for the two cohorts. After adjusting for clinical covariates, off-pump coronary artery bypass grafting did not emerge as a significant independent predictor of long-term mortality (Hazard Ratio 0.91; 95% Confidence Interval 0.70-1.12), readmission to hospital for cardiac cause (Hazard Ratio 0.96; 95% Confidence Interval 0.78-1.10), or the need for reintervention (Hazard Ratio 0.93; 95% Confidence Interval 0.87-1.05). Off-pump coronary artery bypass grafting compared with on-pump coronary artery bypass grafting does not adversely impact survival or freedom from reintervention at a 10-year follow-up.
authors.affiliation: Department of Cardiac Surgery, Harefield Hospital, Hill End Road, Harefield, London UB9 6JH, UK.
authors.forename: Shahzad G
authors.initials: SG
authors.lastname: Raja
authors.forename: Mubassher
authors.initials: M
authors.lastname: Husain
authors.forename: Florentina L
authors.initials: FL
authors.lastname: Popescu
authors.forename: Dimple
authors.initials: D
authors.lastname: Chudasama
authors.forename: Siobhan
authors.initials: S
authors.lastname: Daley
authors.forename: Mohamed
authors.initials: M
authors.lastname: Amrani
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods / Q000401:mortality*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012306:Risk; D017741:Survivors; D016896:Treatment Outcome